was not discontinued when the surgeon activated the laser to Ms.
Tucker's eyelids.
Ms. Tucker suffered second- and third-degree facial burns. Flames
burned her nostrils and nasopharynx. She filed a lawsuit, in which she
claimed the fire made it difficult for her to reach certain notes.
"They caught the laser on fire with the oxygen," said Ms. Tucker in a
release. "The only thing I remember hearing is, 'Get the ambulance, we've
got a fire.' It was the worst thing. I was just saying, 'God, why me?'"
Dr. Sperring says it's worth noting the dangers of airway fires with
lasers when you don't have a closed airway.
"Any source of ignition in an airway that's not a closed circuit is a
no-no," he says. "You don't want a free-flowing source of oxygen and
raised oxygen levels around a source of ignition."
As a reminder when you're using an open gas delivery device (face
mask or nasal cannula, for example), Dr. Sperring cites guidelines
from the American Society of Anesthesiologists (ASA) that state that
before activating an ignition source around the face, head or neck, the
surgeon should give the anesthesia provider adequate notice that he is
about to activate the ignition source.
The anesthesia provider should then stop the delivery of supplemen-
tal oxygen — or reduce the delivered oxygen concentration to the
minimum required to avoid hypoxia — and wait a few minutes after
reducing the oxidizer-enriched atmosphere before approving the acti-
vation of the ignition source, per the ASA guidelines.
And one thing more. "If I were educating people about airway fires,"
says Dr. Sperring, "I would use this photo to tell them this is what not
to do."
Spoken like an anesthesiologist who can sense danger before it hap-
pens.
OSM
A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 9
